De Novo Vasculitis after COVID-19 Vaccination

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic continues to spread around the world. Vaccinations have been administered globally and have been proven to be safe and effective. However, vasculitis has been reported as an adverse event occurring after COVID-19 vaccination.

Methods: In this review, we analyzed the literature to identify original articles that reported on patients who developed vasculitis following COVID-19 vaccination and summarized their clinical manifestations. PubMed and Web of Knowledge were searched to identify relevant studies.

Results: A total of 27 patients who developed vasculitis following COVID-19 vaccination were identified from 21 studies. The involved organs included the skin and kidney. The main clinical features of patients whose skin was affected were papules, maculopapular rashes, and plaques. Most of the patients exhibited small vessel vasculitis and single-organ vasculitis; these were resolved within one month. Patients whose kidneys were affected exhibited vasculitis, including anti-neutrophil cytoplasmic antibody glomerulonephritis and IgA nephritis. Most patients were treated with corticosteroid, rituximab, and cyclophosphamide, and one patient needed hemodialysis. The renal function of most patients was improved or recovered, but one patient needed maintenance dialysis.

Conclusion: Vasculitis was rarely reported after COVID-19 vaccine administration. It often manifested as cutaneous small-vessel vasculitis or glomerulonephritis. Notably, when a patient demonstrates hematuria, proteinuria, and acute kidney injury after COVID-19 vaccination, there is a possibility that the patient could have developed vasculitis. Skin-related problems were quickly resolved, while kidney-related problems may progress to chronic kidney disease.

Keywords: COVID-19; glomerulonephritis; immunization; vaccination; vaccine; vasculitis.